Tia Jackson, MS, LAT, ATC
NPI #1649725938 in Sturgeon Bay, Wisconsin
Provider Information
- NPI Number
- 1649725938
- Entity Type
- Individual
- Name
- Tia Jackson, MS, LAT, ATC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- MS, LAT, ATC
- Enumeration Date
- Aug 17, 2016
- Last Updated
- Feb 19, 2019
Practice Location
- Address
- 323 S 18TH AVE
- City
- Sturgeon Bay
- State
- Wisconsin
- ZIP Code
- 54235-1401
- Phone
- (920) 746-0410
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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